LCIS Diagnosis--What Do I do next?

nala24

LCIS Diagnosis--What Do I do next?

nala24

Hi,

I have been reading this group for a while and I have some questions.  Last week, I had a MRI guided core biopsy and the radiologist called and said they found a large area of LCIS behind the nipple.  The surgeon I saw before the biopsy called and confirmed the diagnosis and suggested I make appointments with  (1) a radiation oncologist; (2) an oncologist; (3) a plastic surgeon to discuss reconstruction; and (4) a second opinion, if I wanted one.  I'm so confused.  He was suggesting PBM, even though he keep telling me that LCIS is not cancer but a precancerous marker.  I called my family doctor and scheduled an appointment to discuss what I do next and what doctors I should make appointments with.  Does anyone know what research hospitals are conducting LCIS studies?  I haven't seen my pathology report yet, should I get a  second pathology diagnosis?  I haven't had a surgical biopsy but have had multiple mammograms and ultrasounds that were not showing anything.  It was the MRI that showed the abnormality.  What questions should I ask my family doctor? What should I do next?  (By the way, the surgeon told me not to get my information from the internet. read.)

Thanks.

Anonymous

Nala
After my LCIS was found on stereotactic core biopsy, I had an wide excisional  biopsy (lumpectomy) to make sure nothing else more serious was in there along with the LCIS.   Has your surgeon mentioned that to you? I'm confused why he would recommend a radiation oncologist, as radiation is not given for LCIS (nor chemo either) as it is non-invasive. But it would be a good idea to be followed by a medical oncologist. I see my oncologist every 6 months; he does blood work, breast exams, coordinates my imaging studies (mammos and MRIs), and monitors my tamoxifen.
  A 2nd opinion is always a good idea and make sure they give you a copy of your pathology report. Having LCIS, we don't have to go thru the "bad stuff" like chemo or rads, but we have our own special set of issues of high risk and the worry that goes along with it. I was diagnosed over 4 and a half years ago. I also have family history that raises my risk even higher, so I take tamoxifen as a preventative medication. Be sure to discuss with an oncologist your individual risks and benefits  of taking tamox, it can help reduce the risk of invasive bc by up to 50%.  Feel free to PM me if you'd like.

Anne 

leaf

Hi there nala. I'm so sorry you are going through this. I'm sorry you had to join our group, but I'm glad you found us.



LCIS (and nothing worse) is a fairly unusual condition. I knew I would never find an in-person support group. One very rough estimate is maybe 1:10,000 women-years, though that may be off by orders of magnitude. http://www.ncbi.nlm.nih.gov/pubmed/12353815?dopt=abstractplus. The incidence is probably increasing. So its not unexpected that you are getting lots of confusing, contradictory answers.



There is hardly anything that is NOT controversial about LCIS. Everything from its name (what it should be called), its frequency (how often it occurs), its natural history (what happens to women who have LCIS), what risk LCIS (and nothing worse) confers, and how it should be managed, are all controversial.





It is not controversial (that I know of) that it was first described in the 1940s by the respected pathologists Foote and Stewart. They named it LCIS. The name stuck even though now most oncologists don't consider it cancer. (An alternative name, which also includes ALH, is 'lobular neoplasia'.) They thought LCIS was like DCIS, but in the lobules. I guess people thought it should be treated the same. They didn't know the natural history of the disease. (They don't know a whole lot more now, but I think that many people feel that MOST women with LCIS do NOT end up getting breast cancer in their lifetime- but this is definitely a VERY controversial area. ) As far as I know, up until about the 1990s, LCIS with nothing worse was routinely treated with bilateral prophylactic mastectomies. Then, when they discovered that early invasive cancer could be treated by lumpectomy + radiation, perhaps most breast surgeons thought that prophylactic bilateral mastectomies was not appropriate treatment for women who did NOT have invasive cancer.





I don't know why you should see a radiation oncologist. I think I've read most of the Pubmed abstracts on LCIS, and I only found 1 or maybe 2 papers where they tried to manage LCIS with radiation. This was in France.



First, get a copy of your pathology report to make sure you only have LCIS and nothing worse.





Second, I would make the decision whether or not you want to be excised http://community.breastcancer.org/topic/95/conversation/702563?page=1#idx_1. If you choose to get excised, they are doing this to help make sure there isn't something worse going on in the area (in other words DCIS or invasive). If you end up having something worse, then you will need to be treated for the 'something worse'.


If you end up 'just having LCIS and nothing worse': if you know right off the bat that you want mastectomies, most surgeons will want you to wait several months to make sure you really want this un-doable operation. Some people have problems with getting insurance coverage (women who are also BRCA positive have a much easier time, because it is generally thought that BRCA confers a higher risk of breast cancer than does LCIS.)





This is what the NCI (National Cancer Institute) says about LCIS. http://www.cancer.gov/cancertopics/pdq/treatment/breast/HealthProfessional/page6



Probably the next step may be whether or not you want to get your slides reread at a major university. I chose to do this last year, but it did cost be over $550/biopsy out of pocket. (Other people have cited less expensive rereads. I guess I live in an expensive area.)





Probably the next step is to see if you have a bad family history - if you want/need to get genetic counseling and/or testing. If there is any question, I would advise seeing a board certified genetics counselor at a major institution. Counselors should give you information about your risk for having a genetic mutation. They should not pressure you one way or another about genetic testing.





Next, is to explore your treatment options. You may want to see an oncologist to see about tamoxifen or other hormonal treatments (in some places they have breast surgeons prescribe hormonal treatments.) You may want to see a plastic surgeon if you are interested in mastectomy reconstruction. You will probably want to be followed by an oncologist or a breast surgeon to have clinical exams and imaging.







LCIS normally never shows up in any imaging technique. Some here have said it showed up in their imaging, but it is not common for it to show up in that way. For most LCIS women, they have suspicious calcifications and they do a biopsy and find LCIS. For most of the other LCIS women, they have a lump and find LCIS as an incidental finding. It is most commonly found as an incidental finding. This means that normally, LCIS does NOT show up on mammograms, ultrasounds, or MRI. It is normally only found on biopsy. Since not all women have breast biopsies, they don't know how many women are running around with LCIS and don't know it.





Most papers I've seen say that LCIS does not need to be excised to the margins. That is because it seems that LCIS confers an increased risk of breast cancer to both breasts, even the parts of the breast that do NOT have LCIS. LCIS seems to confer an increased risk of breast cancer to both breasts, even if there is only one small spot of LCIS in one breast only. Its a strange disease.





When I was diagnosed with LCIS and nothing worse, I thought this will be simple. I'll just find my risk of breast cancer, make my decision, and be on my way. Unfortunately, they don't know the risk of breast cancer for LCIS patients. I have a weak family history, and I have been quoted lifetime breast cancer risks as low as 10% (even less than the average woman in the United States), to 60%, to 80% (the latter figure in a breast cancer model that has NOT been compared to populations, has NOT been peer reviewed, and should NOT be used for clinical decisions.) I was told that my risk (I have LCIS and ALH and a weak family history) is probably close to 10%. Whether I agree with this or not is a different story.





Personally, I think that perhaps one of the more accurate estimates of LCIS risk may be about 0.7-1% per year. This means that in 5 years, your breast cancer risk may be 5x0.7=3.5% to 1x5=5% over 5 years. I think that since they don't know how much risk LCIS confers, it is not known if other risk factors confer a higher risk. For example, if you are 75 years old and have LCIS, it is not known if age (a known risk factor for breast cancer) adds any additional risk of breast cancer to your LCIS diagnosis. For some risk factors, the risks are additive or increased. Risks do NOT have to be additive. For example, if risk factor A confers a 10% risk and factor B confers a 20% risk, if you have both factor A and B, your total risk may be 30%, or it may be 10% or it may be 50%. They have to compare their models to people who actually have both factor A and B.


Because LCIS is so unusual, they don't have this data, or at least I have never seen it.






You can read my other posts, if you wish, about why I think the modified Gail model is very misleading. The modified Gail model is the breast cancer risk model that almost everyone uses to predict breast cancer unless you have a bad family history.





You will see posts here from women who were diagnosed with LCIS that have been recommended everything from bilateral mastectomies, to screening only (annual mammograms with clinical exams, much like the average woman over 50 in the US, but usually people get at least twice a year clinical exams.) Personally, my breast surgeon said "I do not want to do anymore surgery on you."





Treatment is a very individual choice. Since this is a weird, unusual disease, you may want to go to someone more specialized than your GP. I think all the women here are followed by either a breast surgeon or an oncologist.





As to whether or not you should call it cancer: to the question "Do you have a personal history of cancer?" I circle both Yes and No. You do have to be careful or you will spend 10 minutes explaining to the doc the situation with LCIS. You may have to convince them you are not crazy or in denial. ("But there's carcinoma in the name!") I think most oncologists consider LCIS a benign condition. That is because cancer is a continuum. There is not a straight line that separates benign from cancerous cells.





I would say that the current thinking by most oncologists is that LCIS is a marker for higher risk for breast cancer, and in some **unknown, but small** percentage of patients, it may be a nonobligate precursor for cancer. This means that for a small number of LCIS patients, their LCIS **may** or **may not** be on a direct pathway to cancer. That means for a small number of LCIS women, their LCIS may or may not be obligated to become breast cancer.



I think one LCIS woman here goes to Duke University. I heard another patient goes to Dr. Carol Fabian at the Univ. of Kansas.


There is NO RUSH to any of these decisions, unlike others who have worse diagnoses. Do what is best for YOU. Feel free to ask questions.

nala24

Thank you for all the information.  I'm am visting my family doctor today, so he can point me in the right direction as to which doctors to schedule appointments with.  I felt like I needed to sit down with someone who knows me and my determination and will help me get organized in this fight.  Last week, I was just worried and today I "don't have cancer" but a PBM is suggested?????? The radiologist suggested an surgical biopsy, but the surgeon said the area is so large and I'm am so small that I would be so misshapened, that the mastecomy with reconstruction might be the better way.  He seemed to want to rush the procedure. I'm wondering about a surgical oncologist and if you have to go to a big teaching hospital or center to find one.  I think that the surgeon said the radiologist took 24 core samples and they were all positive.

Nala

leaf

People define 'cancer' differently.

Is your surgeon a breast surgeon or a general surgeon? I certainly don't understand why the surgeon says the 'area is so large' as if that is a concern. Most LCIS is multifocal (meaning there are multiple areas of LCIS in a breast) and bilateral (meaning it occurs in both breasts.) (They probably know this from the pre-1990s mastectomy pathologies.)

"No evidence is available that re-excision to obtain clear margins is required. " http://www.cancer.gov/cancertopics/pdq/treatment/breast/HealthProfessional/page6


One of the reasons why this is true is that LCIS cannot be seen by imaging of any kind, so in order to 'get clean margins', they'd have to do mastectomies because the surgeon certainly can't tell by looking at the tissue.




DO NOT BE PRESSURED INTO RUSHING WITH YOUR DECISION, unless you do have 'something worse'- in other words, DCIS or invasive cancer. I've seen veteran posters who DID have invasive breast cancer who have said don't be pressured into making a decision for invasive breast cancer.

That's why its so important to get a copy of your pathology report.

I am over 2 years out of diagnosis, and I still haven't completely decided what to do. (I am currently on tamoxifen.) (I also have other issues.)



In the Port study http://www.ncbi.nlm.nih.gov/pubmed/17206485?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum the overall gross incidence of breast cancer was about 0.7-1% per year. If you are 40 years old now, that would mean that if you lived to be 80, your lifetime risk might be about 40%. That means a 60% chance of NOT having breast cancer. Breast cancer is NOT a death sentence.


The decision is extremely personal and individual. Do what is best for YOU!

moogie

Hey,,,,



Be sure you have access to top notch MRI technology and a radiologist who IS VERY EXPERIENCED reading breast MRI. This is not an easy thing to find. Even in NYC, there are only a few that have this experience basis. In other parts of the US, this is harder to find. The expertise of the reader of the MRI is very crucial in monitoring LCIS. So if you need to travel once a year for a great imaging study at a top notch facility...consider the option.



I went to Duke, and another gal on the boards also goes there. I participated in a study there that monitored breast calls on a regular basis: RPFNA study. It originated out of the University of Kansas, Dr Carol Fabian. Dr Victoria Seewaldt runs Dukes' High Risk CLinic> If you are in NC, I recommend them wholeheartedly. This is more information for you to have, and can contribute to your long term decisions.



I got several opinions at an NCI Cancer center when my pathology was LCIS. I also got a few from local oncologists, and surgeons. From personal experience, I feel an evaluation by a research oriented cancer center, preferably in a high risk breast cancer center , is the option that gives you the cutting edge medicine with the possibility of relieving some of your stress. A team will participate in your care, and that is a good situation. Also any research studies that would help you monitor your condition will be available to you. I travelled several hours round-trip for Duke, and I would do it again in a heartbeat. I feel they saved my life.



If you have any questions, PM me. LCIS is stressful, and we all know how it can weigh on the psyche!Moogie

nala24

I visited my family doctor today and he is making an appoinment for me with a medical oncologist that he highly recommends.  I have the initial pathology report and it states that I have an extensive area of LCIS and that additional tests are being done for DCIS, invasive cancer, and hormone receptors.  I missed a call from the radiologist and I'm afraid one of the other tests may have come back positive.  Can LCIS be found in the ducts?

Thanks

moogie

Since LCIS is in the lobules, it is not in the ducts. DCIS, papillomas, adh can be in ducts.

Try to get an appointment with a surgical oncologist as well, they have a different take on these things than a medical oncologist sometimes. A surgical oncologist specializing in breast cancer is the best resource for surgical approaches to biopsy and more extensive surgery questions.



Are you near a major city?

Moogie

moogie

Just to add something to the mix: very dense extensive areas of LCIS generally raise more alarms than diffuse findings.



Moogie

leaf

I think LCIS can actually spread into the ducts. My pathology report reads "Diagnosis: Lobular Carcinoma In situ with pagetoid spread into ducts (see comment)." In the comment section it says "The largest focus of LCIS measures approximately 0.5cm. There is involvement of several adjacent ducts as well as pagetoid spread along other areas of ductal epithelium." I have also read another poster said she was diagnosed with DCIS with pagetoid spread into the lobules, so I am assuming they can spread in either direction.

nala24

Thanks for the information.

I live about 2 to 3 hours from Phila. and NYC.  Baltimore and DC are about 5 hours away.  I'd be willing to go anywhere in the USA.  I even have a relative in Minnesota, so I've thought about the MAYO.  Has anyone heard anything about the McGee Center in Pittstburgh?  My sister was having her mammo yesterday and the tech said her mother had LCIS and went there. 

Thanks

mtbmom

Nala- my mom goes to St. Agnes in Baltimore for her treatments and has been happy with the care she gets. Good luck!

moogie

Since you are able to access NYC, Perhaps Memorial SLoan Kettering? They have a high risk Breast Center. I also pursued them to re read my slides.

Also Johns Hopkins is a possibility.



McGhee Womens Hospital is good. I lived in Pittsburgh, and heard great things about it....but an NCI Cancer center would be really great for evaluation. Are they an NCI center?

Moogie

dazeeee

hi nala, i was diagnosed with LCIS and have been taking tamoxifen for 3 1/2 years, i had all the same recommendations as you did, and my docs and i decided tamoxifen was the way to go...side effects aren't great, but it's better than the alternative.

by the way, i'n in nyc and went to sloane kettering for my second opinion, i do NOT recommend them, they act like they're doing you a favor....they didn't even read my slides before i got there, and the doctor asked ME what i was diagnosed with....

nala24

Hi everyone,

 Once again thank you. I did get in contact with the radiologist who said that my diagnosis has been changed to DCIS with lobular morphology.  I asked him if LCIS was still there and he said that it was unclear.  He said that they didn't find anything invasive yet and the cells were 80% Estrogen Receptive.  I was confused before, but now ....

The radiologist said my options have changed and I need to do my research and act sooner.  I definitely think that I need another pathology opinion since the results were so different.  He said the slides were sent from my lab  to Dr. Page at Vanderbilt University and he agreed with the DCIS with lobular morphology.  I was planning on seeing a medical oncologist, but he said it is more important that I see a surgeon and radiation onclogist.  He suggested a second opinion at Fox Chase or Sloan Kettering.  Has anyone else had the diagnosis change after additional stains?  What doctor should I see next?  Any opinions about Fox Chase or Sloan Kettering? 

Bren-2007

Hi Nala,

It seems your current doctor is on the right path.  A medical oncologist would not recommend chemo for DCIS.  LCIS morphology, in my opinion, would indicate the DCIS began at the junction of the lobule and duct. 

A breast surgeon can best advise you on what the next step would be regarding the DCIS.  He'll discuss with you all the treatment options, and refer you to a radiation oncologist and plastic surgeon, if necessary. If you can find a good one closer to your home, that's the one I would choose. 

Best of luck to you.

Bren

moogie

Nala:

I have heard that there is someone at Vanderbilt who is a pathology whiz with breast stuff......



My diagnosis changed when my slides were re-read at the NCI place. Some of the pathology business is a judgment call. The more breast cells the place handles...the better.



A surgical oncologist specializing in breast cancer is the next step ,as your doctor advised. Medical oncologists are a different ball game.

Either facility suggested is great. I know many who have dealt with Sloan Kettering and have been pleased with treatment. Sometimes in a major center, the process is developed to move patients through the system with efficiency...and that can lack finesse. At Duke, there was also a level of confusion at first when I made my appointment...and I had to wait while my slides were reread. But places like this have people from all over the world travelling to them for consults, and the volume in my opinion is a factor.

Good luck!!! Both facilites are really good..so there is no wrong decision.

Moogie

NewsMom

I suspect the Vanderbilt pathology expert mentioned is David Page.

My breast surgeon sends her slides to him.  He does consultations.  My surgeon describes him as meticulous.

I searched the Internet, and found that David Page was invited by the NCI to take part recently in a very exclusive panel, determining the criteria for diagnosing various kinds of breast cancer.  

Apparently, "regular" pathologists, who do not specialize in this field, are swimming in a gray area......  I'm relieved to know that this fellow is going to tell me what his expert eyes see on my slides.

moogie

Yes,,,,the Page guy sounds right to me! I researched him myself several years ago. Good for all of us to know that he is a mighty resource. I agree that the run of the mill pathologist does not have the vast experience of someone who specializes in breast diseases and pathology. The guy who does diagnostics only on Porsches, will be a better technician than the local mechanic if you've got one of these cars..........



A second opinion is a very valuable thing....and even if it means more effort...it is well worth going the extra mile,.

Moogie

nala24

Thank you so much for the information!

I did feel better when I saw on the last pathology report that Dr. Page was consulted on my slides.  It seems odd that the ball is rolling without a surgical biopsy.  I have appointments at a radiation oncologist, medical oncologist, and plastic surgeon all within this week.  I asked my surgeon to set up a second opinion at Fox Chase.

I think I also want to have another opinion, maybe at the University of Pennsylvania.  Did anyone set up a "third" opinion consult themselves without making the arrangements through the doctor's office?  I just feel that since the doctor suggested Fox Chase maybe  they regularly concur with him and an outside center may be more objective. 

moogie

I also got 3 opinions. I think if there is major surgery involved, that is not too many.

I set up all my " opinions" myself. After you get your treatment decision set for yourself, which is the most important thing....be sure that the plastics part of the equation is well researched before you decide. Certain types of reconstruction are less successful after radiation, and you want to know what your options are....even if you wait for recon.



My last plastic surgery consult was the one that I chose..after a sobering one before that!!! I realized it is important to have a surgeon you can feel good about, because you will be in reconstruction over the course of a year or more depending on your situation. The same goes for your medical oncologist..this person is in it with you for the long haul. WHoever is going to monitor you health needs to be the best support and advocate!

Moogie

janet516

I just found this LCIS discussion and it is the first I have registered for since being diagnosed with ILC and LCIS over 3 years ago.  You all seem very well informed.  I had a lumpectomy (left), followed by chemo and radiation in 2005.  A year later, I had a stereotactic biopsy for microcalcifications on the right side, which was benign.  Last week, I had another stereo biopsy on the right for a different area of microcalcs, which confirmed LCIS.  My surgeon wants to excise the area, which is right next to my chest wall.  I am concerned that this procedure will remove a lot of tissue, and then lead to a double mastectomy, and I will be sorry I didn't just go to the mastectomy decision directly.  The surgeon thinks it is wise to "find out exactly what is in that area".  Any thoughts?

moogie

Ask the surgeon directly of the excision will be " visually" bad. One said to me " you will have a poor cosmesis and it canot be addressed by plastic surgery". So then I asked: are you saying I will look like a deflated football?



Basically plastics does best when they get to start form scratch. If more that 1/3rd of your breast is going, probably mastectomy would give better cosmetic results. I have had a huge dent and a mastectomy. The mastectomy with reconstruction was easier to get used to and far less disturbing....

Moogie

moogie

Ask the surgeon directly of the excision will be " visually" bad. One said to me " you will have a poor cosmesis and it canot be addressed by plastic surgery". So then I asked: are you saying I will look like a deflated football?



Basically plastics does best when they get to start form scratch. If more that 1/3rd of your breast is going, probably mastectomy would give better cosmetic results. I have had a huge dent and a mastectomy. The mastectomy with reconstruction was easier to get used to and far less disturbing....

Moogie

Peaches70

janet, I understand your concern. I read before my first biopsy about the effects of repeated biopsies on the size and shape of the breasts. I did not want to be diminished piece by piece, although that is what has happened to a certain extent. I have had 4 biopsies on the right breast - 2 stereotactic and 2 excisional. That side is definitely smaller than the left which had only the 1 biopsy. However, it is not noticeable unless I am nude, so only moderately disturbing. I agree with Moogie that you should ask the surgeon directly about the amount of tissue likely to be removed. He/she may not be able to tell you, since things could change once surgery begins. Also, another factor is the size of your breasts now. Smaller breasts (like mine) show the loss of small amounts of tissue more. I don't know...if I were in your place, I might be thinking about the mastectomy as well. Why not go for a second opinion?

Anne

janet516

I will call another surgeon, but they always want to remove, then evaluate, then make the next decision.  I have small breasts, and my lumpectomy made a medium-sized dent that I can live with.  I guess now I will be symmetrical!  Also, I heard that radiation makes reconstruction more difficult, and that the whole process takes a year.  I think I am convincing myself to do the excision, and then go slowly into the next step.  I took tamoxifen for two years, and am now on aromasin for the past six months, so I don't believe they keep you from getting LCIS.  I also have major neck surgery that I just postponed becasue of the latest diagnosis, so I probably should get that done before a PBM.

Janet 

tenley

I was dx'd w/LCIS in May 08.  I've lost 35 lbs, been to three pysch's, taken different anti-depressants and have been non-functional.  I think I need to have a BPM to "get to the other side".  I can't seem to get on with life with this sword of damacles hanging over my head.  Does anyone else feel like they are stuck in limbo and unable to be optimistic about the future due to the LCIS dx? 

Anonymous

Tenley--it breaks my heart to hear of your anquish and turmoil over your LCIS diagnosis.  I'm not sure anything I say will make any difference to you, but I wanted you to know you are not alone, there are quite a few of us dealing with this same issue, and you can always come here for support. I was diagnosed 5 years ago with LCIS and am very closely monitored with mammos alternating with MRIs, frequent breast exams, and just finished my 5 years of tamoxifen 2 weeks ago. when I was going thru a particularly hard time a few years ago, a man I know said "instead of waiting for the other shoe to drop, why not put on that shoe and dance"  I've always tried to keep that in mind.  I've decided not to let LCIS and the fear of invasive bc run my life anymore.

Anne

Kimber

tenley,

This is a very difficult situation to be in with all the controversy about LCIS.  Like Anne, I am waiting for the other shoe to drop - but my sister, who is a survivor said "what if there is no other shoe?"  So I try to think of it that way.  The constant monitoring is very stressful and I feel very alone.  I always have the thought in my head that I will eventually have to have a mastectomy or mastectomies, and I do not want cancer to make that decision for me.  I am young and healthy and I would rather go through it now. I've made the decision that if anything else pops up, I probably will do PBMs.  But then there is the what if????  What if I just never get cancer????  But what if I get it when I am 60?  With my history and my family history, it is likely.  So to answer your question, yes, I feel stuck in limbo, but I am optimistic about the future.

 My MRI is Wed, so I am feeling stressed right now.  I hope that you can come to a place where you are comfortable with any decision you make and your heart and gut will tell you what to do.  Only YOU can make the decision.

Kimber 

Mykidsmom

Kimber - How did your MRI go? Seems like you would have had it yesterday. Here's hoping for good results. Take care. - Jean

To others just dx'd w/ LCIS, sorry to welcome you to our forum. There are many different ways to approach this dx. Many women seem to be able to deal w/ the testing and careful monitoring, others just "want to move on with their lives." I am afraid that I am of the second type. I found the past year of bx's and mammo's and MRI's to be just about enough for me. I am going to have what my BS calls "risk reduction surgery" next month. I am ready for it (I think) and ready to put this phase of my life behind me.

Best of luck to all. Keep in touch. - Jean